Shaping the Future of Spine Care Coverage Policy: Q&A With Dr. Stephen T. Onesti of South Nassau Communities Hospital

Spine
Laura Dyrda -

Stephen T. Onesti, MD, chief of neurosurgery at South Nassau Communities Hospital and past president of the New York State Neurological Society, discusses how spine surgeons can become more politically active and make an impact on healthcare policy in the future.
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Q: What are the biggest challenges facing spine surgeons in terms of healthcare policy today?


Dr. Stephen Onesti:  As spine practitioners, we have to speak for the quality of our care in order to give patients the best possible services. A lot of coverage plans now are much less generous in what they will cover and what they will reimburse. Once you throw in co-payments and deductibles, insurance plans are expensive. Patients may not be aware in many cases that their benefits are being reduced.

We have a role as practitioners to advocate for patients and to help them as best we can. The most important thing is to stand for high quality care; it should be what we are most devoted to. This is difficult because there is a high need for medical services and fewer resources to provide them. There are more budget issues now and money in the government is tighter.

I think these problems are really going to dominate medicine for the foreseeable future.

Q: How can spine surgeons become more involved in shaping healthcare policy?


SO: Our professional organizations, such as the American Association of Neurological Surgeons and the American Orthopaedic Association, are playing an increasingly active role in shaping healthcare policy. I think they are doing an outstanding job.

Additionally, I think we should all be involved in our state societies — not only in the specialty societies but also in the general medical societies.  

Q: What can individual surgeons do to become part of the decision-making process?


SO:
I think it's important for surgeons to identify legislators that are realistic and supportive of quality care. I see neurosurgeons in the United States becoming much more involved in terms of specific proposals. Many in the neurosurgery and orthopedic community are now energized at the national and state level.

Particularly in New York State, spine surgeons feel very passionate about maintaining patient access to specialty care. Many patients who need these services are finding it harder to obtain them, either because of poor insurance coverage or lack of specialty providers, particularly in disadvantaged regions.   

Q: Who can surgeons rely on to partner with them in these advocacy efforts?


SO:
Patients are our best advocates. They are the people who, at the end of the day, are going to support physicians who are trying to help them. Patients are our advocates and we need to educate them on what is happening and encourage them to get involved as well.

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